CROSS-REFERENCE TO RELATED APPLICATIONS
TECHNICAL FIELD
[0002] The present application relates to medical catheters, and more specifically to medical
catheters useful in endovascular and other body lumens.
BACKGROUND
[0003] Medical delivery catheters are well known in the art of minimally invasive surgery
for introduction of fluids and devices to sites inside a patient's body. For example,
balloon dilation of luminal stenoses (e.g., in procedures such as angioplasty or balloon
dilation of a bile duct), stent placement, and introduction of radio-opaque contrast
fluids are common uses of catheters.
[0004] The most widely used form of angioplasty makes use of a dilation catheter having
an inflatable balloon at its distal end. In coronary procedures, a hollow guide catheter
or wire guide typically is used for guiding the dilation catheter through the vascular
system to a position near the stenosis (e.g., to a coronary arterial lumen occluded
by plaque). Using fluoroscopy, the physician guides the dilation catheter the remaining
distance through the vascular system until a balloon is positioned to cross the stenosis.
The balloon is then inflated by supplying pressurized fluid, through an inflation
lumen in the catheter, to the balloon. Inflation of the balloon causes a widening
of the lumen of the artery to reestablish acceptable blood flow through the artery.
In some cases, a stent may be deployed with or instead of the balloon to widen and
hold open the occluded arterial lumen.
[0005] Preferably a catheter used in endovascular lumens will have several physical characteristics.
The profile and shaft size of the dilation catheter should be such that the catheter
can reach and cross a very tight stenosis. Portions of the dilation catheter must
also be sufficiently flexible to pass through a tight curvature or tortuous passageway,
especially in a catheter adapted for use in the coronary arteries. The ability of
a catheter to bend and advance effectively through the endovascular or other lumens
is commonly referred to as the "trackability of the catheter." Another important feature
of a dilation catheter is its "pushability." Pushability involves the transmission
of longitudinal forces along the catheter from its proximal end to its distal end
so that a physician can push the catheter through the vascular or other lumenal system
and the stenoses. Effective catheters should be both trackable and pushable.
[0006] Two commonly used types of dilation catheters are referred to as "long-wire" catheters
and "short-wire" catheters. A long-wire catheter is one in which a wire guide lumen
is provided through the length of the catheter that is adapted for use with a wire
guide that can first be used to establish the path to and through a stenosis to be
dilated. The dilation catheter can then be advanced over the wire guide until the
balloon on the catheter is positioned within the stenosis.
[0007] In short-wire catheters, the wire guide lumen may not extend the entire length of
the catheter. In this type of catheter, the wire guide lumen may extend only from
the distal end of the balloon to a point intermediate the distal and proximal ends
of the catheter. This shorter lumen is the only portion of the catheter contacting
the wire guide. It is sometimes desirable to exchange this first catheter and/or balloon
for a second catheter (e.g., to "exchange out" a balloon catheter, and then "exchange
in" a stent-deployment catheter). The exchange is preferably executed by leaving the
wire guide in place during removal of the first catheter and using it as a guide for
the second catheter. The first catheter is withdrawn or otherwise removed over the
wire guide, and then a second catheter is introduced over the wire guide.
[0008] Short-wire catheters are often easier to exchange than catheters having the wire
guide lumen extending the entire length of the catheter. This is because the wire
guide need not be as long as a "long wire" configuration, which requires that a length
of the wire guide extending outside the patient's body be longer than the portion
of the catheter extending over the long wire guide in order for a doctor or assistant
to maintain a grasp on the wire guide (to avoid undesired movement or displacement
thereof). The short wire guide configuration catheters also create less friction during
mounting and exchange operations due to the shorter wire guide lumen, leading to a
reduced likelihood of displacing the wire guide.
[0009] Catheters for use in endovascular lumens typically require a variation in physical
properties along different portions thereof. For example, a certain degree of stiffness
is required for pushability and trackability near the proximal end while distal end
requires a great deal of flexibility. A catheter having uniform properties throughout
its length poses disadvantages in that it is likely to be too proximally flexible
or too distally stiff. As a result, most catheter shafts (especially endovascular
catheters) are made from multiple materials along the shaft length. For example, a
catheter shaft may have a stiff proximal portion made of metal hypotube, a middle
portion made of a stiff plastic, and a distal portion made of a more flexible plastic.
This combination of materials poses problems of cost and efficiency in construction,
and the junctions provide problematic possibilities for structural failure (such as
binding, kinking, or even separation) as well as requiring specialized connection
means. In another example, a catheter shaft may be made of plastic for a major part
of its length, but have a stiffening wire disposed through a significant portion of
that length to enhance stiffness. Some long wire catheters rely almost wholly on placement
of a wire guide therethrough to retain the needed stiffness, which presents the problems
of length and unwieldiness discussed above. In contrast, the proximal sections of
short wire catheters must have adequate stiffness independent of the wire guide.
[0010] Several different structures for shortened guide wire lumen dilation catheters have
been proposed and used to obtain the desired physical properties described above,
but each of these structures tends to suffer from several disadvantages. For example,
in a short wire catheter having a relatively flexible one-piece plastic design, because
only a small portion of the wire guide extends through the catheter body near the
distal end of the catheter shaft, the wire guide portion does not contribute to the
pushability of the rest of the catheter shaft. As a result, the proximal shaft portion
of such a catheter has low column strength. With such a configuration, the shafts
and guide wire may tend to develop undesirable flexure (e.g., scissoring, bowing,
buckling, kinking) when the balloon is being manipulated in a lumen. This undesired
flexure may cause an irregular exterior surface such as a sharp edge which can in
turn cause injurious abrasions to the inner lining of the artery or other lumen (e.g.
other body lumen or a working lumen of an endoscope). This undesired flexure also
leads to poor pushability and trackability of the catheter. To counteract this deficiency,
some known designs have extended the length of the wire guide lumen and/or provided
additional stiffener elements in the shaft.
[0011] In one design, a significant proximal portion of the catheter shaft is made of a
metallic tubing (commonly referred to as a hypotube), which provides the desired pushability
while maintaining a relatively small outer diameter. The distal portion of the catheter
shaft is a second, more flexible (commonly plastic) tubing. In short-wire catheters
using the hypotube design, a first aperture for introduction of a wire guide to the
wire guide lumen is usually placed in the hypotube near to the distal end thereof.
Alternatively, this first aperture is placed in the second tubing, or near the juncture
between the hypotube and second tubing. These types of catheters, however, present
certain disadvantages. Having the first aperture in the hypotube mitigates the advantages
of a short-wire catheter: the wire guide must be longer, and advantages conferred
by reduced friction are lessened. Having the first aperture at the aforementioned
junction or in the second tubing creates a likelihood of undesired flexure (e.g.,
kinking or bunching) as there will be at least some portion of the more flexible second
tubing unsupported by a wire guide, and therefore lacking column strength. Not only
may such undesired flexure injure an endovascular or other lumen housing the catheter,
but it may close off an inflation lumen or other lumen of the catheter, which is undesirable.
The problems of increased cost of assembly and various mechanical problems presented
by constructing and using a catheter having both semi-flexible hypotube and more flexible
second tubing portions of the same catheter are addressed in the present invention.
BRIEF SUMMARY
[0012] The present invention provides a catheter device, adaptable for use in endovascular
lumens or other body lumens, that has a construction of multifilar cable tubing for
a substantial portion of its length and that is adaptable for use in a short-wire
or long-wire configuration. The embodiments described and claimed herein provide a
catheter shaft having good pushability and trackability. Embodiments of the present
invention are adaptable for a variety of applications (e.g., placement of expandable
stents, balloon dilation of stenoses) and use in a variety of surgical locations (e.g.,
vascular, gastroenterological).
[0013] The embodiments herein are adaptable for use in a variety of minimally invasive surgical
treatments (including, e.g., angioplasty or bile duct dilation).
BRIEF DESCRIPTION OF THE DRAWINGS
[0014]
FIG. 1A is a perspective view of a catheter, with an enlarged detail view of the catheter's
distal end;
FIG. 1B is a perspective view of a tapered catheter device, with an enlarged detail
view of the catheter's distal end;
FIG. 2 is a perspective view of a catheter shaft with a sleeve;
FIG. 3A is a perspective view of a catheter device having a distal extension and an
inflation balloon, with an enlarged detail view of the features at the catheter's
distal end;
FIG. 3B is a perspective view of a catheter device with an inflation balloon;
FIG. 4A is a perspective view of a catheter device having an external distal wire
guide lumen structure, with an enlarged detail view of the features at the catheter's
distal end;
FIG. 4B is a perspective view of a catheter device having an external distal wire
guide lumen structure and an inflation balloon, with an enlarged detail view of the
features at the catheter's distal end;
FIG. 4C is a perspective view of a catheter device with a distal dual lumen structure
having a wire guide lumen structure and a mounting portion;
FIGS. 5A-5B show a side view of catheter devices having a distal extension and a wire
guide lumen structure;
FIG. 5C is a side view of a catheter device having an external distal wire guide lumen
structure and an inflation balloon;
FIG. 6 is a side view of a tapered catheter device having an external distal wire
guide lumen structure and an inflation balloon;
FIG. 6A is a detail of FIG. 6 and shows a longitudinal cross-sectional view of the
tapering portion and external wire guide lumen of a catheter device;
FIG. 6B is a detail of FIG. 6 and shows a longitudinal cross-sectional view of the
distal portion of the catheter device, with an enlarged detail view of features where
the catheter shaft meets the balloon;
FIG. 6C is a transverse cross-sectional view of a dual-lumen mounting sleeve;
FIG. 6D is a transverse cross-sectional view along line 6D-6D of FIG. 6B showing two
lumens of the catheter device surrounded by a mounting sleeve;
FIGS. 7A and 7B illustrate a cross-sectional view of another embodiment of a catheter
device
FIG. 8 illustrates a partial cross-sectional view of yet another embodiment of a catheter
device.
DETAILED DESCRIPTION
[0015] The presently described embodiments of a multifilar tube catheter shaft are adaptable
for use in a variety of minimally invasive surgical applications (e.g. endoscopic
procedures, angioplasty).
[0016] FIGS. 1A-1B illustrate an embodiment of a catheter device 100 with a shaft 101 constructed
of a multifilar material and having an internal lumen 102. The multifilar tubing described
is made of a plurality of wires twisted together and leaving a central lumen. Such
multifilar tubing may be obtained, for example, from Asahi-Intecc (Newport Beach,
CA). Materials and methods of manufacturing a suitable multifilar tubing are described
in Published
U.S. Pat. App. 2004/0116833 (Koto et al.), the contents of which are incorporated herein by reference. Use of multifilar tubing
in a vascular catheter device is described in
U.S. Pat. No. 6,589,227 (Sonderskov Klint, et al.; Assigned to Cook Inc. of Bloomington, Indiana and William Cook Europe of Bjaeverskov,
Denmark), which is also incorporated herein by reference.
[0017] In FIG. 1A, the exterior diameter 107 is approximately the same along the length
of the shaft 101. In the embodiment shown in FIG. 1B, the proximal end 104 has a greater
exterior diameter than the distal end 106. The catheter shaft 101 tapers toward a
smaller exterior diameter 108 at the distal end 106. Tapering can enhance flexibility
of the shaft 101 in several ways. For example, flexibility is enhanced by decreasing
the outside diameter of the catheter shaft 101. The portion of the catheter shaft
101 having a smaller diameter is more flexible than the portion having a larger diameter.
Such tapering also decreases the thickness of the wall of the catheter shaft 101.
Alternatively, tapering may be used within the internal diameter of a catheter, enhancing
flexibility by decreasing wall thickness without altering the exterior diameter of
the shaft 101. The steepness and location of the tapering is determined by the desired
application for the catheter shaft 101. For example, in alternative embodiments, there
may be multiple stepwise or gradual differences in diameter to confer different degrees
of flexibility throughout the length of the catheter. For example, catheter shaft
101 for use in coronary arteries will typically benefit from a smaller diameter than
a catheter shaft 101 for use in a bile duct, both for gross size and flexibility.
A grinding process or other suitable process may be used to reduce the exterior diameter
as appropriate for the desired application. Reducing the exterior diameter provides
an added benefit by reducing the profile of the device. The flexibility of the catheter
shaft 101 or a portion thereof may also be altered by increasing or decreasing the
number of filars. In one aspect, the embodiments described herein also provide a catheter
shaft having consistent construction material throughout most of the length of the
catheter shaft, with gradual transition from a stiffer proximal end to a more flexible
distal end and lacking sharp transitions that undermine structural integrity.
[0018] A further embodiment of the catheter shaft 101 includes a coating on internal and/or
external surfaces for at least a portion of the catheter shaft 101. The coating is
selected to confer or improve one or more properties of reduced friction, flexibility,
and sealing a lumen 102 of the catheter. Sealing the lumen 102 allows the lumen to
be used, for example, for introduction of inflation fluid to a dilation balloon or
introduction of a medicative substance or radio-opaque contrast fluid.
[0019] The coating may be, for example, a sheath or sleeve 202 as illustrated in FIG. 2.
In various alternative embodiments, the sheath 202 may comprise an extruded sleeve,
shrink tube, extruded over-jacket, or dip coat. The sheath 202 is preferably a thermoset
material or a thermoplastic material and may comprise, for example, HDPE, PTFE, PEBA,
PET, polyurethane, polyimide, polyolefin, nylon, or any combination thereof. The coating
may be applied by, for example, over-extrusion, dip-coating, melt fusion, or heat
shrinking. For example, PET shrink tube 202 has the advantage of providing an increased
stiffness to a small diameter catheter shaft 201. On the other hand, a PEBA (Polyether
Block Amide) shrink tube 202 can be used with a larger diameter catheter shaft 201
where greater flexibility is desired. The type of sleeve 202 material may also be
selected to complement other catheter components; for example, a nylon sleeve 202
may bond and interact better with a nylon expandable member such as a balloon or basket
and/or a nylon wire guide lumen. Selection of coating materials, filar size and number,
and diameter allow manipulation of the catheter shaft's 201 shore hardness to offer
the desired functional properties.
[0020] FIGS. 3A-3B illustrate embodiments of balloon catheters 300 comprising a multifilar
shaft 301. In the embodiment of FIG. 3A, the catheter shaft 301 has a distal extension
302, upon which is mounted an inflation balloon 304. The distal extension 302 can
be formed of the same group of materials used in the coating (HDPE, PTFE, PEBA, PET,
polyurethane, polyimide, polyolefin, nylon, or any combination thereof) and provides
a shaft portion that may be more flexible than the shaft 301. As can clearly be seen
in the detail illustration portion of FIG. 3A, the extension 302 encloses an inflation
lumen 306 which continues from an inflation lumen 306 of the multifilar catheter shaft
301. The extension 302 also encloses a wire guide lumen 308. In the illustrated long
wire configuration catheter 300, the wire guide lumen extends from the proximal end
of the multifilar catheter shaft 301 and extends through the inflation balloon 304
at the distal end.
[0021] The embodiment illustrated in FIG. 3B has an inflation balloon 304 disposed directly
on the distal end of the catheter shaft 301. An inflation lumen 306 of the multifilar
catheter shaft 301 opens into the inflation balloon 304. A wire guide lumen 308 traverses
the interior of the balloon 304, continuing the wire guide lumen 308 of the catheter
shaft 301 to a point distal of the inflation balloon 304. An expandable stent 312
is positioned about the balloon 304. In an alternative embodiment, an expandable member
other than a balloon (e.g., a basket) is disposed near the distal end of the catheter
shaft 301. Such an embodiment optionally may have a wire guide through the expandable
member. At its proximal end the catheter 300 has a port 310 in fluid communication
with the inflation lumen 306. In an alternative embodiment, the port 310 offers access
to the guide wire lumen 308. The port 310 may be included in other embodiments, and
in other positions on the catheter 300. In another alternative embodiment, the catheter
shaft 301 has two ports 310, offering separate access to each of the inflation lumen
306 and the wire guide lumen 308. In other alternative embodiments, the port 310 is
useful for introducing another fluid such as a contrast fluid.
[0022] FIGS. 4A-4B illustrate embodiments of a multifilar tube balloon catheter device 400
comprising a multifilar shaft 401 and further comprising an external, distally disposed
short wire guide lumen structure in the form of a cannula 402 having a wire guide
lumen 404 disposed therethrough. In FIG. 4A, the cannula 402 is attached on the distal
end 408 of the multifilar catheter shaft 401 using an adhesive. Alternative means
of attachment include, for example, forced convection heating, radio frequency heating,
ultrasonic welding, and laser bonding. Alternatively, shrink tubing may be used as
a manufacturing aid to help compress and fuse the cannula 402 to the multifilar catheter
shaft 401. The shrink tubing may be removed and disposed of after the cannula 402
is connected to the catheter shaft 401, or may remain on as part of the connected
structure. If the multifilar catheter shaft 401 has a coating, the cannula 402 may
be bonded to the coating or directly to the catheter shaft 401. A heat shrink tubing,
for example PEBA, may be applied over the entire assembly, which increases the strength
of the assembly. In the embodiment shown in FIG. 4B, the cannula 402 is constructed
of multifilar tubing. An inflation balloon 406 is mounted on the distal end 408 of
the catheter shaft 401. An inflation lumen 405 of the catheter shaft 401 is open to
the interior of the inflation balloon 406. The cannula 402 extends through the inflation
balloon 406 and has an extension 407 on its distal end. A wire guide lumen 404 runs
through the length of the cannula 402 and its extension 407. Although not shown, it
should be appreciated that an expandable stent can be disposed about the balloon 406.
The cannula 402 providing a wire guide lumen structure can be formed of HDPE, PTFE,
PEBA, PET, polyurethane, polyimide, polyolefin, nylon, or any combination thereof.
In one embodiment, the cannula 402 comprises a PTFE inner liner and a PEBA outer cover.
Other materials may be used as an inner liner such as, for example, HDPE, PET, and
polyimide.
[0023] In FIG. 4C, a dual lumen structure 410 is disposed on the distal end 408 of the multifilar
catheter shaft 401. A portion of the length of dual lumen structure 410 has a "figure
8" cross section. A mounting portion 412 of the dual lumen structure 410 has a lumen
414. The distal end 408 of the catheter shaft 401 fits into the lumen 414. The lumen
414 may be completely occupied by the distal end 408 of the catheter shaft 401, or
may continue coaxially beyond the distal end 408 so as to form an extension. If the
mounting portion 412 is placed as an extension, the lumen 414 is in fluid communication
with a lumen 420 of the shaft 401. A wire guide portion 416 of the dual lumen structure
410 has a wire guide lumen 418 running therethrough. The dual lumen structure 410
is attached on the distal end 408 of the catheter shaft 401 using one of the attachment
methods described for the embodiment shown in FIG. 4A. In this embodiment, the lumen
414 of the dual lumen structure is in fluid communication with a lumen 404 of the
catheter shaft 401. In an alternative embodiment, a part of the mounting portion 412
is mounted inside the lumen 420 of the catheter shaft 401.
[0024] FIGS. 5A-5C illustrate embodiments of a balloon catheter 500 incorporating a multifilar
shaft 501 and having a short wire guide configuration. The embodiments shown in FIGS.
5A-5B each have a coaxial extension 502 of the multifilar shaft 501, a short wire
guide lumen structure in the form of a tube 504, and an inflation balloon 506. The
coaxial extension 502 may have the same or a different flexibility than the multifilar
shaft 501. In the embodiment illustrated in FIG. 5A, the proximal end 508 of the tube
504 is disposed distal of the juncture of the extension 502 with the multifilar shaft
501. The tube 504 enters the extension 502 and extends through the distal end of the
balloon 506. Thus, this embodiment comprises a distal extension of the shaft (in this
case the coaxial extension 502) and the wire guide lumen structure 504, a portion
of the wire guide lumen structure 504 being coaxial within the distal extension, another
portion of the wire guide lumen structure 504 being outside the distal extension adjacent
thereto.
[0025] In the embodiment illustrated in FIG. 5B, the proximal end 508 of the tube 504 is
disposed proximal of the juncture of the extension 502 with the multifilar shaft 501.
The tube 504 enters the extension 502 and proceeds through the distal end of the balloon
506. Thus, this embodiment comprises a distal extension of the shaft (in this case
the coaxial extension 502) and the wire guide lumen structure 504, a portion of the
wire guide lumen structure being coaxial within the distal extension, another portion
of the wire guide lumen structure 504 being outside the shaft adjacent thereto. The
embodiment illustrated in FIG. 5C does not have an extension. The balloon 506 is disposed
on the distal end of the multifilar shaft 501. The proximal end 508 of the tube 504
is disposed proximal of the juncture of the extension 502 with the multifilar shaft
501 and is affixed to the exterior of the multifilar shaft 501. The tube 504 passes
through the middle of the balloon 506 and proceeds through the distal end of the balloon
506. In each of the embodiments shown in FIGS. 5A-5C, the placement of the proximal
end 508 of the tube 504 along the multifilar shaft 501 affects the flexibility of
the shaft 501. Therefore, variation in the placement is useful in increasing or reducing
flexibility as desired in other embodiments.
[0026] FIG. 6 illustrates one embodiment of a balloon catheter 600 having an elongate shaft
601 comprising a multifilar tube. An inflation balloon 602 is disposed near the distal
end. FIG. 6A is an enlarged detail illustration of a middle section of the catheter
600. As can be clearly seen in FIG. 6A, the shaft 601 includes an external wire guide
lumen 604 and an internal inflation lumen 606. As shown in FIG. 6A, this embodiment
the catheter shaft 601 is coated with a PEBA coating 603. The coating 603 serves to
reduce friction during introduction of the catheter shaft 601 and provides a seal
to prevent leakage of inflation fluid from the inflation lumen 606 through the walls
of the shaft 601. As can also be seen in FIG. 6A, the catheter shaft 601 tapers distally
to a smaller diameter along the region 605.
[0027] FIG. 6B is an enlarged detail illustration of a distal section of the balloon catheter
600. As shown in FIG. 6B, the inflation lumen 606 opens into the inflation balloon
602, and the wire guide lumen 604 extends through the balloon 602 to the distal end
607. FIG. 6B includes an enlarged detail portion more clearly illustrating the relationship
between the balloon 602 and the two lumens (604 and 606). In this embodiment, the
balloon 602 and wire guide lumen 604 are mounted to the shaft 601 with a PEBA shrink
sleeve 608. As shown in FIG. 6C, a cross-sectional view of the sleeve 608 has approximately
a figure-eight shape before mounting. The sleeve 608 has two central apertures (610
and 612) to allow mounting the sleeve 608 over the wire guide lumen 604 and the shaft.
In this embodiment, after the balloon 602 and wire guide 604 are assembled to the
shaft 601 together with the sleeve 608, the sleeve 608 is heated to shrink and form
to the assembly of shaft 601, balloon 602, and wire guide 604. FIG. 6D is a transverse
cross section along line 6D-6D of FIG. 6B, and shows the finished configuration. The
sleeve 608 forms to the shaft 601 and leaves open the inflation lumen 606 and the
wire guide lumen 604.
[0028] Cross-lumen communication may be prevented. For example, the walls of the multifilar
tube of the elongate shaft 601 may be porous, and pressure exerted on an inflation
fluid in the inflation lumen 606 may urge inflation fluid into the wire guide lumen
604. According to one aspect, this may be prevented by lining the wire guide lumen
604 with a liner such as, for example, PTFE, although other materials may be used.
Furthermore, an inner coating segment may be placed over the elongate shaft 601 beneath
the proximal breach or side opening of the wire guide lumen 604. The inner coating
segment may be, for example, PEBA. The inner coating segment may be implemented to
alter flexibility in the area of the segment, for example to avoid abrupt changes
in flexibility. In one embodiment, the proximal end of the segment terminates at about
halfway through the taper and the distal end of the segment terminates just distal
of the proximal breach or side opening of the wire guide lumen 604. According to another
aspect, cross-lumen communication may be prevented by placing the coating 603 over
essentially the entire length of the elongate shaft 601, and the sleeve 608 may subsequently
be placed over the coating 603 and elongate shaft 601. According to yet another aspect,
cross-lumen communication may be prevented by simply making the walls of the sleeve
608 thicker. A 0.001 inch (0.025 mm) wall thickness of the coating 603 or sleeve 608,
for example, may be sufficient. As mentioned previously, the coating 603 and sleeve
608 may be PEBA,. These principles may be implemented in other embodiments of the
invention as may be desirable due to fluid being passed through or injected into one
of the lumens.
[0029] FIGS. 7A-7B illustrate a cross-sectional view of a portion of a catheter device 700
according to one aspect of the present invention. A shaft wall comprising multiple
filars 702 includes an inner coating 701 and an outer coating 703, and surrounds a
first lumen 704 and a second lumen 706. A wire guide 708 extends through the first
lumen 702, and a stent-deployment shaft 710 extends through the second lumen 706.
As shown in FIG. 7A, the catheter device 700 includes a distal extension 712 that
houses a self-expandable stent 714. FIG. 7B illustrates the stent 714 having been
pushed out of the second lumen 706 by the stent-deployment shaft 710 such that the
stent 714 is deployed. Prior to deployment of the stent 714, the wire guide 708 is
typically retracted into the shaft wall or lumen 704 so as not to interfere with deployment
of the stent 714.
[0030] FIG. 8 illustrates a partial cross-sectional view of another embodiment of a catheter
device 800, including a self-expanding stent 810. The catheter device 800 has a central
lumen 802 surrounded by a first, outer tubular multifilar body 804. A second, inner
multifilar cable tube is coaxially disposed in the central lumen 802 for use as a
pusher 806. The pusher 806 has a protruding engagement surface 808 for pushing the
self-expanding stent 810 out of the central lumen 802 or for holding the stent 810
as the outer tubular multifilar body 804 is being pulled in a proximal direction.
A tapered tip 12 is mounted on the distal end of the pusher 806, and provides a minimally
traumatic leading surface for the catheter device 800. A wire guide 814 extends through
a central wire guide lumen 816 of the pusher 806. Optionally, apertures (not shown)
may be provided through the side of the outer tubular body 804 and the pusher 806
to permit the wire guide 814 to exit the central lumen 802 and the wire guide lumen
816 at an intermediate location. The self-expanding stent 810 is adapted to be deployed
when a user retracts the outer tubular body 804 proximally while holding the pusher
806 substantially in place. The protruding engagement surface 808 of the pusher 806
holds the self-expanding stent 810 substantially in place while the outer tubular
body 804 is withdrawn from around it. Once the stent 810 is deployed, the pusher 806
and wire guide 814 are withdrawn, leaving the stent 810 in the position where it was
deployed.
[0031] In alternative embodiments, the shaft coating (if any) may be a material other than
PEBA, and may be the same or different than the material in a mounting sleeve used
to mount a balloon (for example, HDPE, PTFE, PET, polyurethane, polyimide, polyolefin,
nylon, or any combination thereof). In other alternative embodiments, the multifilar
catheter shaft need not have a lumen running through its length, but may be relatively
solid (e.g., for use as a pushing tool, or for use in a configuration not requiring
a lumen through the catheter shaft). The balloon catheters of the present invention
are adaptable for use with expandable stents as is illustrated, for example, in FIG.
3B.
[0032] It is therefore intended that the foregoing detailed description be regarded as illustrative
rather than limiting, and that it be understood that it is the following claims, including
all equivalents, that are intended to define the spirit and scope of this invention.
[0033] The following numbered clauses set out specific embodiments that may be useful in
understanding the present invention:
- 1. A catheter device, comprising:
an elongate catheter shaft comprising a multifilar tubing having a proximal portion
and a distal portion wherein at least a part of the distal portion is more flexible
than the proximal portion.
- 2. The catheter device of clause 1, the multifilar tubing defining a first lumen,
and further comprising a second lumen.
- 3. The catheter device of claim 2, wherein at least one of the first and second lumens
is adapted for passage of a wire guide.
- 4. The catheter device of clause 1, further comprising a distal extension of the shaft.
- 5. The catheter device of claim 4, further comprising a wire guide lumen disposed
upon at least the distal extension.
- 6. The catheter device of clause 1, further comprising a distal extension of the shaft
and a wire guide lumen, a portion of the wire guide lumen being coaxial within the
distal extension, another portion of the wire guide lumen being outside the distal
extension adjacent thereto.
- 7. The catheter device of clause 1, further comprising a distal extension of the shaft
and a wire guide lumen, a portion of the wire guide lumen being coaxial within the
distal extension, another portion of the wire guide lumen being outside the shaft
adjacent thereto.
- 8. The catheter device of clause 1, the multifilar tubing defining a first lumen,
and further comprising
a self-expanding stent;
a second lumen;
and a stent deployment shaft disposed in the second lumen.
- 9. The catheter device of clause 1, further comprising a polymeric coating, said coating
covering at least a region of the shaft.
- 10. The catheter device of clause 9, further comprising an expandable balloon.
- 11. The catheter device of clause 10, wherein the balloon comprises the same polymer
as the coating.
- 12. The catheter device of clause 1, further comprising at least one of an inflation
lumen or an expandable member disposed at a distal end of the shaft.
- 13. The catheter device of clause 12, further comprising a deployable stent disposed
about the expandable member.
- 14. The catheter device of clause 12, wherein the expandable member comprises a balloon.
- 15. The catheter device of clause 14, comprising the inflation lumen and wherein the
inflation lumen is in fluid communication with a lumen of the balloon.
- 16. The catheter device of clause 12, wherein the expandable member comprises an expandable
basket.
- 17. The catheter device of clause 1, further comprising a self-expanding stent.
- 18. The catheter device of clause 1, further comprising an external wire guide lumen
attached near the distal end.
- 19. The catheter device of clause 1, further comprising an external wire guide lumen
mounted near the distal end, wherein the wire guide lumen is disposed through at least
a portion of an expandable balloon lumen of a balloon attached to the distal portion.
- 20. The catheter device of clause 1, further comprising a balloon-deployable stent.
- 21. A catheter device, comprising:
an elongate catheter shaft comprising a multifilar tubing having a proximal portion
and a distal portion, the multifilar tubing defining a first lumen, and further comprising
a second lumen.
- 22. The catheter device of clause 21, wherein at least a part of the distal portion
is more flexible than the proximal portion.
- 23. The catheter device of clause 21, wherein at least one of the first and second
lumens is adapted for passage of a wire guide.
- 24. The catheter device of clause 21, further comprising a distal extension of the
shaft.
- 25. The catheter device of clause 24, wherein said second lumen is a wire guide lumen
disposed upon at least the distal extension.
- 26. The catheter device of clause 21, further comprising a distal extension of the
shaft, the second lumen being a wire guide lumen, a portion of the wire guide lumen
being coaxial within the distal extension, another portion of the wire guide lumen
being outside the distal extension adjacent thereto.
- 27. The catheter device of clause 21, further comprising a distal extension of the
shaft, the second lumen being a wire guide lumen, a portion of the wire guide lumen
being coaxial within the distal extension, another portion of the wire guide lumen
being outside the shaft adjacent thereto.
- 28. The catheter device of clause 21, the multifilar tubing defining a first lumen,
and further comprising
a self-expanding stent;
and a stent deployment shaft disposed in the second lumen.
- 29. The catheter device of clause 21, further comprising a polymeric coating, said
coating covering at least a region of the shaft.
- 30. The catheter device of clause 29, further comprising an expandable balloon.
- 31. The catheter device of clause 30, wherein the balloon comprises the same polymer
as the coating.
- 32. The catheter device of clause 21, further comprising at least one of an inflation
lumen or an expandable member disposed at a distal end of the shaft.
- 33. The catheter device of clause 32, further comprising a deployable stent disposed
about the expandable member.
- 34. The catheter device of clause 32, wherein the expandable member comprises a balloon.
- 35. The catheter device of clause 34, comprising the inflation lumen and wherein the
inflation lumen is in fluid communication with a lumen of the balloon.
- 36. The catheter device of clause 32, wherein the expandable member comprises an expandable
basket.
- 37. The catheter device of clause 21, further comprising a self-expanding stent.
- 38. The catheter device of clause 21, the second lumen being an external wire guide
lumen attached near the distal end.
- 39. The catheter device of clause 21, the second lumen being an external wire guide
lumen mounted near the distal end, wherein the wire guide lumen is disposed through
at least a portion of an expandable balloon lumen of a balloon attached to the distal
portion.
- 40. The catheter device of clause 21, further comprising a balloon-deployable stent.
1. A short-wire balloon catheter comprising:
an elongate shaft having a proximal end and a distal end and comprising a multifilar
tube, the shaft having an internal inflation lumen; the shaft having a sheath which
serves to reduce friction during introduction of the shaft and to prevent leakage
of inflation fluid from the inflation lumen; the shaft tapering distally to a smaller
diameter;
an external, distally disposed short wire guide lumen structure in the form of a cannula
having a wire guide lumen disposed therethrough, the wire guide lumen having a liner
to prevent inflation fluid being urged into the wire guide lumen; and
an inflation balloon disposed near the distal end of the shaft, said inflation lumen
opening into the balloon and said wire guide lumen extending through the balloon.
2. The balloon catheter of claim 1, further comprising an inner coating segment placed
over the elongate shaft beneath a proximal breach or side opening of the wire guide
lumen.
3. The balloon catheter of claim 2, wherein a distal end of the segment terminates just
distal of the proximal breach or side opening of the wire guide lumen.
4. The balloon catheter of claim 3, wherein a proximal end of the segment terminates
at about halfway or less through said taper.
5. The balloon catheter of any one of the preceding claims, wherein said sheath comprises
a polymeric coating and wherein the balloon preferably comprises the same polymer
as the coating.
6. The balloon catheter of any one of the preceding claims, wherein the wire guide lumen
structure is formed of HDPE, PTFE, PEBA, PET, polyurethane, polyimide, polyolefin,
nylon, or any combination thereof.
7. The balloon catheter of any one of claims 1 to 5, wherein the wire guide lumen structure
comprises a multifilar tube.
8. The balloon catheter of any one of the preceding claims, wherein the wire guide lumen
liner is formed of PTFE, HDPE, PET, or polyimide.
9. The balloon catheter of any one of the preceding claims, wherein the sheath comprises
an extruded sleeve, a shrink tube, an extruded over-jacket, or a dip coat.
10. The balloon catheter of any one of the preceding claims, wherein the sheath is a thermoset
material or a thermoplastic material.
11. The balloon catheter of any one of the preceding claims, wherein the sheath comprises
HDPE, PTFE, PEBA, PET, polyurethane, polyimide, polyolefin, nylon, or any combination
thereof.
12. The balloon catheter of any one of the preceding claims, wherein the sheath is applied
by over-extrusion, dip-coating, melt fusion, or heat shrinking.
13. The balloon catheter of any one of the preceding claims, wherein the wire guide lumen
is mounted to the shaft with a sleeve.
14. The balloon catheter of claim 13, wherein the sleeve has two central apertures to
allow mounting the sleeve over the wire guide lumen and the shaft.
15. The balloon catheter of any one of the preceding claims, further comprising a deployable
stent disposed about the expandable member.